Provider Demographics
NPI:1073552907
Name:KWOK, LYANNA (DPT)
Entity Type:Individual
Prefix:MRS
First Name:LYANNA
Middle Name:
Last Name:KWOK
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:MISS
Other - First Name:LYANNA
Other - Middle Name:
Other - Last Name:LY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:21475 RIDGETOP CIR
Mailing Address - Street 2:
Mailing Address - City:STERLING
Mailing Address - State:VA
Mailing Address - Zip Code:20166-6580
Mailing Address - Country:US
Mailing Address - Phone:703-433-0401
Mailing Address - Fax:703-433-0490
Practice Address - Street 1:21475 RIDGETOP CIR
Practice Address - Street 2:
Practice Address - City:STERLING
Practice Address - State:VA
Practice Address - Zip Code:20166-6580
Practice Address - Country:US
Practice Address - Phone:703-433-0401
Practice Address - Fax:703-433-0490
Is Sole Proprietor?:No
Enumeration Date:2006-06-06
Last Update Date:2008-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA018236P55Medicare PIN